Vigilance and Public Health

by Justin B. Moore, PhD, MS, FACSM

Aldous Huxley once stated, “Eternal vigilance is not only the price of liberty; eternal vigilance is the price of human decency”; a riff on the oft attributed quote on the price of liberty (alone). Although spoken many decades ago, the author’s words are as true now as they have ever been. The United States has undergone régime change, and the incoming leadership campaigned on a promise to repeal the Patient Protection and Affordable Care Act (ACA) as a first order of business. Regardless of our political leanings, we as public health professionals must remain especially vigilant during this process in light of the public health gains made under the ACA, ensuring that the president-elect and his cabinet indeed “broaden healthcare access, make healthcare more affordable and improve the quality of the care available to all Americans” in the process of repealing and replacing. Fortunately, this campaign promise is unambiguous and measureable. If access to healthcare is indeed broadened, then public health surveillance systems will capture these data, just as they have under the current administration. Furthermore, we can assess affordability, as authors in the Journal of Public Health Management & Practice (JPHMP) have done previously, examining state coverage of clinical preventive health services for working-age adults or the health-care related financial burden of underinsurance. Finally, if we are to assess change in the quality of healthcare available to Americans, the JPHMP has published a systematic review of quality indicators to guide these efforts. In short, we have the means and a roadmap to assess the success of the public health efforts of the incoming administration, and we must continue our efforts to utilize them.

As pointed out by JPHMP author, Brenda Stevenson Marshall, about the ACA, a change in America’s leadership and resulting public health policies represents a “natural experiment,” one that we as public health scientists and practitioners must observe, document, and evaluate. This must be done with transparency, rigor, and vigilance, not only because assessment and assurance are in our job description, but because it is the price of human decency.

For further reading, consider these related articles from the Journal of Public Health Management & Practice*:

*Articles may require a subscription to JPHMP or purchase.


Justin B. Moore, PhD, MS is the Associate Editor of the Journal of Public Health Management & Practice and an Associate Professor in the Department of Family & Community Medicine of the Wake Forest School of Medicine at the Wake Forest Baptist Medical Center in Winston-Salem, NC, USA. Follow him at Twitter and Instagram. [Full Bio]

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